Hughes A J, Colosimo C, Kleedorfer B, Daniel S E, Lees A J
Department of Neurology, Middlesex Hospital, London, UK.
J Neurol Neurosurg Psychiatry. 1992 Nov;55(11):1009-13. doi: 10.1136/jnnp.55.11.1009.
Fifteen of 23 pathologically confirmed cases of multiple system atrophy (MSA) showed some initial response to levodopa and eight of these remained at least partially responsive at the time of death. Eleven developed motor oscillations, and drug-induced dyskinesias, often involving the face and jaw, were also seen in 11 cases. Acute levodopa and apomorphine challenges were administered to 11 patients with clinical MSA who were considered levodopa responsive. A short duration relatively small amplitude response with associated dyskinesias occurred in six and a further three developed dyskinesias without any motor response. Following levodopa withdrawal, a delayed deterioration occurred after three to six days in six patients, five of whom had shown no short duration motor response to the acute challenges. The occurrence of levodopa-induced dyskinesias without a concomitant motor response and delayed deterioration several days after levodopa withdrawal may be more typical of patients with MSA than Parkinson's disease.
23例经病理证实的多系统萎缩（MSA）病例中，有15例对左旋多巴有一些初始反应，其中8例在死亡时仍至少有部分反应。11例出现运动波动，11例还出现药物性异动症，常累及面部和下颌。对11例临床诊断为MSA且被认为对左旋多巴有反应的患者进行了急性左旋多巴和阿扑吗啡激发试验。6例出现持续时间短、幅度相对较小的反应并伴有异动症，另外3例出现异动症但无任何运动反应。停用左旋多巴后，6例患者在3至6天后出现延迟性病情恶化，其中5例对急性激发试验未表现出短时间的运动反应。左旋多巴诱发的异动症不伴有相应运动反应以及在停用左旋多巴几天后出现延迟性病情恶化，可能在MSA患者中比帕金森病患者更为典型。
